- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.41 / $13.82 / $155.22
| Facility | | $4.41 | $13.82 | $155.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.14 / $6.57 / $8.94
| Professional | | $5.14 | $6.57 | $8.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.63 / $4.63 / $4.63
| Professional | | $4.63 | $4.63 | $4.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.44 / $8.42 / $23.55
| Facility | | $3.44 | $8.42 | $23.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.86 / $3.82 / $10.28
| Professional | | $2.86 | $3.82 | $10.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.59 / $7.73 / $12.37
| Facility | | $4.59 | $7.73 | $12.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.74 / $17.01 / $24.51
| Facility | | $7.74 | $17.01 | $24.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.74 / $9.50 / $11.88
| Professional | | $4.74 | $9.50 | $11.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $10.05 / $48.47
| Professional | | $8.44 | $10.05 | $48.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $3.48 / $13.53
| Professional | | $1.71 | $3.48 | $13.53 |